Player's Name: (first) _____________________ (last) _______________________ Date of Birth: (day) ____ (month) ____ (year) ____ Current Age: ________ Address: _______________________________________ (apt#) _____________ City/Town: (city) ____________________________ (postal code) __________ Phone: (home) (___)_________ (work) (___)_________ (FAX) (___)_________ Email: _____________________ Height (feet/inch): ___________________ Weight (lbs): ___________________ If player is under 18, Parent/Guardian's Name: ____________________________ Parent/Guardian's Phone: (____)______________________
Hockey Shirt Size (check one): Adult S ________ M ________ L ________ XL ________ XXL ________ Youth YS _______ YM _______ YL _______ YXL _______ Sweater Number: 1st choice ________ 2nd choice ________ 3rd choice ________ Do you have any friends who want to play roller hockey? (1) Name: ____________________________ Phone: (____)______________________ (2) Name: ____________________________ Phone: (____)______________________ Please give us info on people who could coach/manage a team: (1) Name: ____________________________ Phone: (____)______________________ (2) Name: ____________________________ Phone: (____)______________________
Do you play hockey? Yes _________ No _________ If Yes, Number of years _________ Have you ever played roller hockey? Yes _________ No _________ If Yes, Number of years __________ Position(s) played: F _______ D _______ G _______ Position desired in roller hockey: F _______ D _______ G _______ Level(s) of Ice Hockey played: House _______ Select _______ A _______ AA _______ AAA _______ Adult _______ University _______ Other ______________________ Curent Ice Hockey team (if any): _______________________________
The applicant agrees that the Metro Toronto and Region Roller Hockey League and/or its Proprietors will not be held responsible for any accident or loss however caused, and agrees to release the Proprietors from all claims or damages which may arise as a result of such accident or loss. In the event of inability to contact me, I hereby give you permission to seek out any necessary medical assistance I or my child may require while attending the roller hockey program. The applicant agrees to abide by all stated and written rules and regulations of the game or roller hockey as administered by the Metro Toronto and Region Roller Hockey League. The applicant agrees to abide by the rules of the referees and coaches involved in the program. The applicant agrees to participate in the spirit of good sportsmanship at all times.
_______________________________________________________________ Name (Parent or Guardian) _______________________________________________________________ Signature (Parent or Guardian) _______________________________________________________________ Signature (Applicant) _______________________________________________________________ Date
Note: Helmet (full face mask or visor) is required for all players under 18 years. Half visor is recommended for adults. Since the game is non-contact, no upper body equipment will be needed.
The registration fee is $100 Canadian funds, payable by cash, certified cheque, or money order to MTRHL. For more information, please contact CIRSA.
Please print this form, complete it, and mail it with the registration fee to:
679 Queens Quay West, Unit 117
The women's league will play games every Sunday night, except for the long weekends, throughout the summer. The games will run between 6pm and 9pm on Sunday night at the North York Centennial arena. Three teams from the league will travel to the North American Roller Hockey Championship in Vancouver in August 1997.